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Active NPI 1316087307 Individual Practitioner Female Practitioner

Shannon L Samples , TBS COORDINATOR

Counselor • Upper Lake, CA

Professional Overview & Biography Verified Profile Summary

Shannon Samples, TBS COORDINATOR is a registered healthcare professional specializing in Counselor in Upper Lake, CA. Practice services are available at 9860 MIDDLE CREEK RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9860 Middle Creek Rd

Upper Lake, CA 954859265

Telephone 7072758166
Fax 7072758168

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Upper Lake, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
12 Specialists

Practicing in Upper Lake, CA (14303 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
NPI 1124283890

MHREHABSPECIALIST

NPI 1144409517

REHABSPEC

NPI 1407996705

MHREHABSPEC

Rayna Freedman , MFT INTERN

Marriage & Family Therapist

NPI 1538207360

MFTINTERN

Kathryn Reisig , MFT

Marriage & Family Therapist

NPI 1578719134

Marriage and Family Therapist

Shanti Gallon , CASE MGR, HSW

Case Manager/Care Coordinator

NPI 1669654232

CASEMGR, HSW

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 9860 MIDDLE CREEK RD, UPPER LAKE, CA 954859265 (Tel: 7072758166)

📍
Updated Business Mailing Address July 08, 2007

Registered at 8357 SADDLE RD, KELSEYVILLE, CA 954517847

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as SHANNON SAMPLES, TBS COORDINATOR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor

🟢
Initial NPI Registration & Enumeration February 07, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316087307
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2007
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

8357 Saddle Rd

Kelseyville, CA 954517847

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.